1. Reproductive Choices

2. Chapter 5 Reproductive Choices
Learning Outcomes:
Describe the process of conception
Discuss the problem of infertility and alternate methods of having children
Discuss the pros and cons of various methods of contraception
Discuss methods of abortion
Discuss health issues in pregnancy and prenatal development
Describe health issues associated with methods of childbirth
Discuss health issues in the postpartum period

3. Conception Union of a sperm cell and an egg cell
Zygote: Fertilized egg
Females: XX Males: XY
Miscarriages (spontaneous abortions) of male fetuses more prevalent
Fertilization normally occurs in a fallopian tube. The zygote travels down to the uterus and implants into the wall.

4. Infertility Male Fertility Problems Female Fertility Problems
Sperm: low count, low motility, irregularly shaped
Causes: genetic factors, age, injuries, drugs, blood pressure medications, environmental toxins, stress
Female Fertility Problems
Irregular ovulation or failure to ovulate, obstructions or malfunctions of reproductive tract, endometriosis, age-related decline of female sex hormones

5. Increasing Fertility Inducing Ovulation Increasing the sperm count
Artificial insemination
ICSI (Intracytoplasmic Sperm Injection)
Inducing Ovulation
IVF (Invitro fertilization)
GIFT (game intrafallopian transfer)
Donor IVF
ZIFT (Zygote intrafallopian transfer)
Embryonic Transfer
Surrogate Motherhood
Adoption

6. Contraception Consider effectiveness, ease of use, health risks
Hormonal Methods
progestin or combination of progestin and estrogen
Oral contraceptives – “The Pill”
Injectable, patches, “morning-after pill”
No protection against STIs
Health risks for women who smoke, are obese, older, hypertension, or a history of vascular disease
Intrauterine Device (IUD)

7. Contraception Methods
Barrier Methods
Condoms
Latex protect against STIs
Less effective than oral contraceptive or IUD
Diaphragm
Shallow latex cup or dome
No protection against STIs
Spermicides
Contraceptive Sponge
Cervical cap

8. Contraceptive Methods
Fertility Awareness (Rhythm Methods)
Calendar BBT Ovulation
No protection against STIs
Low reliability
Sterilization
Vasectomy
Tubal sterilization (tubal ligation)
Hysterectomy

9. Abortion Purposeful termination of pregnancy Methods
Vacuum aspiration (90% - safest)
Dilation and Curettage (D & C)
Dilation and Evacuation (D & E) – 2nd trimester
Intra-amniotic infusion – 2nd trimester
Intact Dilation and Extraction (intact D & E)
RU-486

10. Pregnancy
Early Days
Human chorionic gonadotropin (HCG) produced (OTC pregnancy tests – HCG in urine)
“morning sickness”
Prenatal care important

11. Stages of Prenatal Development
Germinal Stage
Conception to implantation
Embryonic Stage
Implantation to 8th week
Neural tube (3 weeks) – importance of folate
Fetal Stage
9th week until birth
Major organ systems, fingers, toes, external genitals are formed by end of 1st trimester
Factors that may adversely affect health of embryo/fetus:
drugs, X-rays, environmental contaminants, infectious organisms

12. Childbirth
Three Stages 1st Stage: Labor - contractions efface and dilate cervix, ending with transition 2nd Stage: transition, “hard labor” culminating with delivery 3rd Stage: Delivery/Expelling of Placenta

13. Methods of Childbirth Anesthetized Childbirth
General
Local: Blocks – pudendal, epidural, spinal
Prepared Childbirth – The Lamaze Method
Can be used in combination with anesthetics
Cesarean Section
1 in 3 births now done by C-section

14. Birth Problems Oxygen Deprivation
Prenatal hypoxia can impair central nervous system development
Prolonged oxygen cutoff at delivery can cause cerebral palsy or death
Preterm and Low-Birth Weight Children
Preterm < 37 weeks Low birth weight < 5 lbs
Neurological and cognitive functioning impaired
Muscles are immature, weakened sucking & breathing reflexes
Respiratory distress syndrome

15. The Postpartum Period Postpartum Depression (PPD)
“baby blues” normal – generally last 1-2 weeks
PPD – more serious and persistent mood changes
Symptoms: sadness, hopelessness and helplessness, major changes in appetite, sleep patterns, difficulty concentrating, severe fluctuation in mood
Breast-Feeding Versus Bottle Feeding
Benefits of Breast-Feeding
Reduces risks of infections, and incidence of allergies